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� <br />�� � • DUYLUING PF.RD�I'P APPLTCATIOP� • � . <br />�'� � , • • 7lpplicant To Compl.etc T.l�is Porm ' � <br />Tf m:e th�n one buildi.nq i,�to be c:onstructcd, sub�nit a separ.at•e Per.mi.t � <br />appli:•ation L•or caclt buildinc�. A �cp�irat•e per.mil• wi.11 bc isstiicd fo�: cach <br />- builcir�q. . � • <br />, �' � y a'c_ • . <br />: Owner `�� S�i1/'�tousa,l .:� .Duilding Jlddress ,7.,;;`�� ..�.�, .�� <br />Ac]dress ��• "$ok IT"%. . Lo� riloc}: <br />City L���ArtaoD Phone 77lv-1Z�Z Subdiyision (Plat) • <br />� Arehi.ect/Engincer • • • . <br />City Phone Metc:� t, I3ounds (UnplatLed) <br />. Contsactor o,�.�� Sec. � T�ep. T.g... . <br />RBdr;:s � <br />City Phone ', •h.�� S.n� � <br />.State License Number _�2'S-OI-68�1 � • <br />• Er.pizz:ion Date 3-1-71v <br />� TRACT 3� � <br />Lots 6 and 7, the Nnrth 1.0 foot of Lot• 5 and the South <br />I1.0 feet of Lot 8 Blocl: U5:i Carfield Sc�c� �d Addition to <br />EvereLt, as platt�d and r�corded in Volume�' of Ylets, <br />Page�') , Records of �nohomish Cuui�ty, Washington. <br />- • Number of Stories <br />.• , . , ` •Basement <br />. � , � � "' • Ne�•� ' Addition .Itepai.r./P.emodel <br />�, . , • ... ' . Valuation of Cor.struction $ ' <br />_ ' ' �l8 Q�iO - <br />%T�-� ` ` � <br />_ • : , . . Signed IIy �'� i11�'"lf��u�c� <br />. ' • . . . : . . Por <br />' � , ' . . Owner • Phone • <br />- y ..`:; i � . . '. . ' : . ' . • • • . <br />_ : ' Do t;ot IVritc Below Thi� Lir.e -For City Use Only � <br />- � •, '�Date Received • ' ' ' ' ' ' • • � Use Sonc ' • ,_ <br />1'lan C;�eck Number ' • . Fisr. 2one <br />Valuation � ' • Occupancy •Group <br />Pernit I'ee • .'Type oi Con:;truction • ' <br />� 'Plan Check Fee Occupant Load <br />Total Fee Due _ Sprinlc7.crs Rcquired <br />. Datc Is�ucd • � . . . . ' . , • <br />•..,: . � � ;,. . . . • . � :.� . .. � ... • . ::� <br />• ' � .. • ,.. . , . . - " <br />.. , • . '.. <br />::• . . . • • . . . . . - <br />